Interpreting IDEXX LaserCyte* Dx/IDEXX LaserCyte* Hematology Analyzer Dot Plots

Dot plots are a visual representation of the complete blood count. They are beneficial for quickly interpreting and verifying results. This poster will help you identify various diseases on feline or canine dot plots generated from the LaserCyte Dx/LaserCyte analyzer.

Normal RBC Dot Plot (Canine) Abnormal RBC Dot Plot (Canine) Normal WBC Dot Plot (Canine) Abnormal WBC Dot Plot (Canine)

Leukopenia/Neutropenia
Regenerative Anemia

Eosinophils
Neutrophils Eosinophils
Neutrophils
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Red Blood Cells Platelets
Lymphocytes qualiBeads
Monocytes
Reticulocytes Doublets
Mature red blood cells Basophils uRBC

Reticulocytosis RBC Fragments Lymphocytes

Monocytes
qualiBeads

Platelets

Granularity Granularity Granularity Granularity

Normal RBC Dot Plot (Canine) Abnormal RBC Dot Plot (Canine) Normal WBC Dot Plot (Canine) Abnormal WBC Dot Plot (Canine)

Lymphoid Leukemia
Thrombocytopenia

Eosinophils

Neutrophils Neutrophils Eosinophils

Light Absorption

Light Absorption

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Red Blood Cells Platelets Lymphocytes qualiBeads
Monocytes
Mature red blood cells Reticulocytes Doublets Basophils uRBC

RBC Fragments Lymphocytes

Monocytes
qualiBeads
Normal platelet density Decreased platelet density

Granularity Granularity Granularity Granularity

Normal WBC Dot Plot (Feline) Abnormal WBC Dot Plot (Feline) Normal WBC Dot Plot (Feline) Abnormal WBC Dot Plot (Feline)

Platelet Clumping
Neutrophils Neutrophils
Eosinophils Eosinophils Neutrophils Eosinophils
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Light Absorption

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Light Absorption
Eosinophils Neutrophils Eosinophils

Lymphocytes qualiBeads Lymphocytes qualiBeads

Monocytes
Monocytes
Basophils uRBC Basophils uRBC

Lymphocytes Monocytes Monocytes

qualiBeads Lymphocytes qualiBeads
Eosinophilia

Granularity Granularity Granularity Granularity

Normal WBC Dot Plot (Canine) Abnormal WBC Dot Plot (Canine)

Eosinophils
For more information about LaserCyte dot plots,
Neutrophils Neutrophils Eosinophils
contact IDEXX Technical Support.
Light Absorption

Light Absorption

Lymphocytes qualiBeads
Monocytes
Basophils uRBC IDEXX Technical Support Australia 1300 44 33 99
Lymphocytes Monocytes U.S./Canada/Latin America 1-800-248-2483 New Zealand 0800-102-084
qualiBeads
Europe 00800 1234 3399 Asia 0800-291-018

Granularity Granularity
Regenerative Anemia
Reticulocytosis (an increased number of reticulocytes) is the hallmark and most objective indicator of a bone marrow response.
It is most commonly used to accurately identify a regenerative anemia but may also be seen with a variety of other conditions,
including partial and complete compensated hemolytic disease. Reticulocytes are easily identified as the magenta dots to the
right of the red blood cell population (red dots). The new methylene blue stain in the CBC5R tubes precipitates the residual
reticulum in these immature red blood cells, which gives these cells increased granularity and therefore the shift to the right.
In the normal dot plot, there are dramatically reduced numbers of the reticulocytes, noted as a decreased density of magenta
dots, when compared to the patients with significant increases in reticulocyte numbers. Rapid review of the dot plot allows quick
validation of the reticulocyte count and therefore confidence in results generated.
Thrombocytopenia
Thrombocytopenia can be a critical finding in a CBC, and rapid validation of results from the hematology analyzer is essential.
In the red blood cell and platelet dot plot, severe thrombocytopenia is easily validated. In the normal patient dot plot, there are
dense accumulations of blue dots that represent individual platelet optical profiles. During severe thrombocytopenia, the density
of the blue dots is dramatically reduced compared to normal. Because platelet clumping or partial sample clotting may interfere
with the recognition of platelets by the analyzer and they may not appear on the dot plot, rapid microscopic evaluation of a blood
film in any case of reported decreased platelet counts is warranted. This is true for all hematology analyzers used for in-house
testing as well as commercial and academic reference laboratories.
Eosinophilia
Recognition of increases in eosinophils (eosinophilia) is an important observation that directs diagnostic investigations towards
specific diseases, such as allergies, parasites, and many others. Because they are of such value, rapid validation of reported
eosinophilia is quite important. In the dot plots, eosinophils (green) are located to the left of the neutrophils in the dog and to the
right of the neutrophils in the cat. Different patterns are seen for different species because of their somewhat unique morphologic
features. In the cases where a significant eosinophilia is reported, the increased density of the eosinophil dot clouds make the
rapid confirmation of increased numbers of these cells simple.
© 2013 IDEXX Laboratories, Inc. All rights reserved. •06-28904-01
*LaserCyte is a trademark or registered trademark of IDEXX Laboratories, Inc. or its affiliates in the United States and/or other countries.
Leukopenia/Neutropenia
Leukopenia or a decrease in total leukocyte numbers and, in particular, neutropenia or decreased in neutrophil numbers often
have high clinical significance related to overwhelming inflammatory disease and possible effects of chemotherapy—immediate
knowledge of these situations is critical to the veterinarian. Marked decreases in leukocytes can be rapidly validated by examining
the WBC dot plot. When an isolated cell type such as the neutrophil is significantly decreased, it is easily recognized because
of the obvious lack of or dramatic decrease in density of the dot plot cloud associated with that particular leukocyte. In these
cases, there is a leukopenia characterized by a marked neutropenia; note the absence of the cloud of purple dots that represent
individual neutrophils in the sample.
Lymphoid Leukemia
Leukemia has multiple presentations; one of the most common is lymphoid leukemia either as a result of progression of
malignant lymphoma or primary lymphoid leukemia originating in the bone marrow. Most advanced hematology analyzers cannot
accurately characterize these circulating malignant cells. In many cases, the analyzers attempt cellular characterization, but
because of difficulty in differentiating the different types of leukocytes, an Abnormal WBC Distribution message is reported to
assure that there is follow-up evaluation of a blood film or submission to a reference laboratory for validation of the analyzers
attempts. In the normal WBC dot plots, there are distinctly identified clouds of different colored dots that represent the different
populations of leukocytes typically seen in the peripheral blood. However, in the dot plots from the lymphoid leukemia patients,
clear distinction between the different leukocyte clouds is not present; there is a continuum between different colored clouds. In
these cases, including the appropriate message code indicating that the analyzer had difficulty in making an accurate leukocyte
characterization along with a blood film or EDTA sample submission to the reference laboratory is recommended.
Platelet Clumping
Platelet clumping is a common problem in veterinary medicine, especially with feline samples. Any time there is difficulty
in sample collection resulting in a delay in placing sample into the EDTA tube or delay in proper mixing, there is a potential
for platelet clumping. There are different degrees of platelet clumping, and most advanced analyzers have the capability of
recognizing large platelet clumps. When identified, an appropriate message is relayed to the operator along with qualification
of selected results that could be impacted by the platelet clumping. The analyzer may still provide values; however, if there are
qualifiers relayed or message codes reported, further evaluation and confirmation of the reported values is essential. A rapid
review of the dot plots can also provide the operator with very quick validation that large platelet clumps are present. Platelet
clumps will be recognized as a linear cloud of dots almost parallel to the lymphocyte/monocyte populations. A rapid blood film
review can allow timely recognition of large platelet clumps and verification of results reported. If platelet clumps are reported or
observed on the blood film, collection of a new sample for analysis is recommended.